Pessary offer documentation in women undergoing surgery for pelvic organ prolapse at a tertiary care hospital

Abstract

Background: Women report similar functional outcomes after pessary treatment or surgery for pelvic organ prolapse (POP). Aims: To assess the documentation of pessary counselling in women who underwent surgery for POP. Methods: This was a retrospective cohort study conducted on women who underwent hysterectomy for prolapse. The primary outcome measure was documentation regarding offer of pessary. ‘Pessary offer’ was defined as documentation that clearly stated that the care provider offered pessary to the patient. Findings: Over the study period, 81 hysterectomies took place for POP; pessary offer was documented for only 19 (23.5%) case records. Characteristics significantly associated with pessary offer were history of chronic cough (P=0.031), previous pelvic surgery (P<0.001), no secondary indication for surgery (P=0.012), concomitant surgery performed other than hysterectomy (P=0.046), age range (P<0.001) and BMI range (P<0.001). Conclusion: Pessary offer was documented in less than quarter of cases. This denotes a need to strengthen documentation of offer, counselling for pessary, or both of these.